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A while back I wrote about how arthritis was messing with my life. I complained about sore feet and sore hands. If I had written the post at 2:00AM I might have described sore feet, sore hands, sore back, sore hips, and a sore soul. Despite all of that, I feel okay most of the time. But I am not stupid and know that I need to make lifestyle changes to help reduce joint pain.

As someone who has lived with Type 1 diabetes for 41 years, I have gotten used to the idea that more than doctors and pills, I am the one in charge of my health. I make the conscious decision to monitor my blood sugar, eat reasonably well, and optimize my insulin regimen. But as I look atthe last 4 decades, I strongly believe that I am healthy today because of exercise: tennis, golf, hiking, dog walking, step classes. Unfortunately I am finding that arthritis demands that I no longer hike 12 miles in the Arizona mountains or walk 6 miles on my hilly Minnesota golf course. Weight lifting benefits my biceps but my hands suffer. Planks and push-ups strengthen my core, but my elbows and shoulders rebel. Almost everything bothers my feet.

One of the benefits of my Medicare supplement plan is Silver & Fit where I can join a health club for free. In 2017 I selected the nearby Lifetime Fitness and enjoyed cardio, strength, and cycling classes. Unfortunately this spring I began to realize that despite trying to modify exercises to my capabilities, these classes were too taxing on my joints.

Thanks to a local diabetes friend, I was persuaded to check out the Southdale YMCA. She has belonged there for years and calls it her “home away from home.” She mailed me a copy of the long list of fitness and pool classes, some designed for seniors and others targeted for exercisers of various ages and fitness levels. After being faced with the possibility of both foot and hand surgery, I determined that it was time to check out the Y.

I stopped by one rainy morning in May and was immediately welcomed and taken on a tour. With little hesitation I joined on the spot. Fate determined that my free orientation session was with a trainer who happens to have a sister with Type 1 diabetes! We talked about exercise and low blood sugar and she showed me the stash of glucose tabs in the file cabinet at the fitness desk.

The senior exercise classes are organized under an umbrella of ForeverWell. There are three activity tiers: Just Getting Started, Already Active, and Exercising Regularly. Aging, illness, and surgery can shift you from one category to another and the boundaries are fluid. I am a good fit for “Exercising Regularly” classes and faithfully attend ForeverWell Yoga and occasionally ForeverWell Strength. I also participate in several cycling classes each week.

ForeverWell Yoga:Imagine a studio filled with 75 people over the age of “don’t ask-don’t tell” and many well into their 70’sand maybe 80’s. You need to arrive early to get a spot although no one is ever turned away. The instructor uses kindergarten teacher skills to quiet the noisy group to get started at 8:15 on Tuesdays and Thursdays and reminds us to take care of injuries and sore joints. A long warm-up is followed by instruction in poses that increase strength, flexibility, balance, and mental health. There is something really inspiring about seeing a roomful of seniors in child’s pose or warrior two. I plan my life around never missing this class and I always leave feeling better than when I arrived.

ForeverWell Strength:This class is mostly attended by women with an occasional guy hanging out in the back row. The formula is a step warm-up, strength work with weights and an elastic band, various exercises with a small ball, and then a cool down. None of it is hugely difficult, but the always-moving and always-smiling instructor keeps us on the go and I get a good workout. When I attend this class, it means that Abby the Black Lab misses her morning walk with friends at the dog park. My health versus the dog’s happiness. It’s a tough choice except on rainy days.

Studio Cycle: Studio cycling gives me an intense cardio workout without the pounding of running, hiking, and step classes. The bikes are a tech wonder where I enter data about myself and get a personal fitness number to measure whether I am in the target zone of white (take a nap), blue, green, yellow, or red (Ferrari). Each of the many different instructors has pushed me to test my limits while pedaling and sweating to great music playlists.

Other Classes:The Y class schedule is amazing with 12 to 30+ classes offered daily and I am in no danger of running out of things to try. Although I lack motivation for individual workouts, many people lift weights, use fitness machines, swim laps and do all sorts of things apart from organized classes.

Of course the YMCA is not only for seniors. I enjoy the age, race, and fitness diversity of the membership and have been happy to see kids everywhere this summer. I see lots of uber-fit young adults and fondly remember those days.

But the magic of the Southdale Y for me is that it embraces seniors. It is a social club with coffee and newspapers in the lobby. The prequel to yoga class is a noisy affair where new and old friends chat and laugh. The fitness area revolves around one longtime Y member who spends his mornings on a rowing machine and attracts a steady stream of chitchatting visitors. The friendliness is contagious and on my second visit to a noontime water aerobics class, I was invited to join the group that goes out to lunch once a month. The ForeverWell Newsletter mentions things like bingo, hearing screenings, and balance classes—things that you expect to see at a senior center. But it also offers an Al and Alma’s Lake Minnetonka Cruise, a trip to Winona, and an invitation to help landscape the exterior of the building.

This talk of senior fitness and community is a bit schmalzy but I know that my mother’s senior years were lonely. She would have been happier and healthier with daily interactions with other people. I remember when my in-laws moved into an assisted living facility and my father-in-law felt alienated because the residents looked so old. Of course they were no older than he was, but he didn’t see that he was “them.” What I love about the YMCA is that I look at “them” and am comfortable being “them.” I am in the early years of being a senior, but I see respect for every person of every age and every level of health and fitness. I don’t see condescension towards older people or actually towards any people. Everyone is welcomed and appreciated at the Southdale YMCA and I am glad to be part of the Y community.

In the spring of 2015 I wrote a couple of blogposts (here and here) about how much I enjoy using a Fitbit and how I find it to be a motivating addition to my diabetes toolbox. A year and a half later I am still using my Fitbit and participating in a regular challenge with members of the diabetes community. (Thanks to Sue R who invites me every week!)

Although I am a self-motivated Fitbit user and would tackle my daily step goal without DOC competition, I still enjoy the motivation resulting my daily interactions with other D-people. Recent thoughts include:

I have a good chance of beating Kerri of Six Until Me in a challenge for the first time ever because she had a baby by C-section two weeks ago. I wouldn’t be so stupid as to place a bet on my results once that “little tomato” “biscuit” “fourth chair” is a month old….

My trick of attaching my Fitbit One to my pump tubing is gaining traction as I recently witnessed Scott Johnson borrow an old-style Fitbit (Zip and One, unlike the more recent bracelet models) so that he could clip it to his pump tubing to track his steps on the basketball court.

David E has moved from being an “also-ran” to an unbeatable champion almost every week. I’m not sure that he is more active these days. I think that he is just becoming better at syncing his Fitbit so that his steps count.

Just so your know! On Monday Fitbit added a new do-it-yourself challenge called “Adventures.” If you click on “Challenges” from your phone/tablet Fitbit home screen, you’ll see a section called Adventures. This allows you to select a daily or multi-day hike to challenge yourself and receive the rewards of 180º photos at landmarks along the trail. Today I selected the Vernal Falls hike which requires 15,000 steps. (The options that show up in your adventures are based on your average steps.) Although my daily goal is 10,000 steps, my average is closer to 15,000 and that is why all of my adventure options require a lot of steps. As I type this blogpost, I am 331 steps short of my goal and I will walk around the house this evening to make sure I reach my destination.

Because I am a hiker, I enjoy the idea of “Adventures” and it is something different from my normal goals. If you need motivation to pull your Fitbit out of the junk drawer, check out Adventures on the Fitbit website and see if it interests you. If nothing else, you can download some new wallpapers from the Yosemite Adventure as seen below:

I went to court last month. Was I nabbed by the diabetes police? Nope. How about the regular police? Not them either. Was I dragged into the legal system for breaking the rules by dosing insulin off my CGM? Nothing like that. So what was I doing?

I was getting my ducks in a row.

What does that have to do with Social Security and Medicare? The answer to that is a lot.

As you approach your initial sign-up date for retirement benefits under Social Security, you need to be sure that you have the required documentation for your claim. According to the Social Security Administration (SSA) website, in most circumstances you will need the following documents:

My advice is to consider this list at least 3 months before signing up for Social Security so that you will have time to obtain any missing documents. Although I had a copy of my birth certificate, I chose to get a certified copy just to be safe. It took about 3 weeks to get the official document from the vital records department of my birth state.

“Even if you don’t have all the documents you need, don’t delay signing up for Social Security. You can submit any documents you do have. You can provide the missing documents later or we may be able to help you get them.

If you delay signing up, you could lose some benefits you may be due.”

So why did I have to go to court?

I had to get a court order for an official name change. Since 1976 I have had a discrepancy between the middle name on my driver’s license and the middle name on my Social Security card. When I got married I chose to keep my maiden name as my middle name and abandoned my previous middle name. Or so I thought. I went to Social Security and had a card issued in my new name. When we moved to Minnesota, the DMV required me to use the old middle name on my driver’s license. I don’t remember how my passport was handled, but it has always matched my driver’s license. So my two main forms of ID for the last forty years have not matched my tax information, bank accounts, and everything else that we own.

I should have fixed this discrepancy years ago, but it amazingly has never been a problem. Thinking of approaching Social Security and handling our assets in our senior years, I finally determined that it was time to resolve the issue.

Changing your name is not difficult. I didn’t need to use an attorney, but did so because a good friend was willing to help me. I filled out a lot of paperwork, seemingly the same thing over and over again. I signed a form allowing for a criminal background check by the FBI. I completed another form for a background check by the MN BCA (Bureau of Criminal Apprehension). More than once I signed that I was not changing my name for fraudulent reasons or to hide assets. On my scheduled court date, I went before a judge with two witnesses and received an official court order for a name change.

With the certified copy of my court order, I have applied for a new driver’s license and will apply for a new passport once the DL arrives.

It is possible that my name discrepancy might not have been noticed with my Social Security application. However in our increasingly ID-conscious society, it seemed to be an unnecessary risk to be a citizen with two aliases. Two aliases sounds so criminal compared to two middle names….

I don’t know everything about Social Security and Medicare yet, but at least I have my ducks in a row. Most of you won’t have to go to court to get ready for Medicare. However, you may have other things that should be taken care of as you enter this new stage of your life.

My health insurance life is imploding and exploding. I can’t tell the difference between what I know and what I don’t know. What I heard last week isn’t true this week and might change again next week. In January I wrote about dreading Medicare. Today I think it might be the best thing that could happen to me.

On June 23 Blue Cross Blue Shield of Minnesota (BCBS) announced that it will discontinue full-service plans in the individual health insurance market beginning in 2017. This follows the exit or reduction in offerings by other companies in previous years. Minnesota was one of the states that created its own insurance exchange in 2014 after the implementation of the Affordable Care Act (ACA) and the results have been devastating for many of the 6% of citizens seeking individual insurance in the state. (The individual market covers people who do not have access to employer-based coverage and are not eligible for Medicaid or other public programs.)

BCBS of MN is the only company so far to announce its exit from the 2017 individual market. Unfortunately it is the largest insurer in the market and its departure will affect 103,000 of the approximately 300,000 Minnesotans who purchase individual insurance. The recent announcement by BCBS follows a premium hike of over 50% in 2016. This increase was justified by the carrier’s reported loss of $265 million dollars in the 2015 individual market.

My 2016 monthly premium was 61% higher than in 2015 and was accompanied by a slightly higher deductible. If BCBS is continuing to experience unsustainable losses with the huge premiums that I am paying, my fear is that no company will be able to survive longterm in this market. Unfortunately as rates soar, many young and/or healthy individuals are choosing or being forced to go without insurance. The downward spiral of an unsustainable market is intensified as the insured population gets older and sicker and costs skyrocket.

I have no idea what the landscape for the individual insurance market in Minnesota will look like next year. It seems questionable that the remaining players can absorb the 103,000 people stranded by BCBS. Will other insurers pull out? Will exorbitant premiums, high deductibles, limited networks, and poor coverage be the norm? What will be the effects of the presidential election with one candidate vowing to repeal the ACA?

All I know is that I received a letter that says:

“We regret to inform you that at the end of this year, Blue Cross and Blue Shield of Minnesota will be discontinuing all individual and family insurance plans sold to members in Minnesota directly, through an agent or broker, or on MNsure. As a result, you will not be able to renew your current plan or select another Blue Cross plan for coverage in 2017.”

I personally only have to deal with this for three months in 2017 and will transition to Medicare on April 1. I know others who do not have this option. Some of them have Type 1 diabetes and the outlook is bleak.

First, I can sign up for Medicare three months before my 65th birthday and January is seven months away.

Secondly, I will be doing most of my research this fall in a period that overlaps with the October 15 – December 7 open enrollment period for all Medicare beneficiaries. That is good because there will be a lot of 2017 plan information available at that time. That is bad because most insurance brokers and company representatives will be busy and it might be hard to get individual attention.

Thirdly, as someone with a pre-existing health condition, my initial selections can have lifelong effects. If I do not choose a Medigap (Supplemental) policy during my one-time Medigap Open Enrollment Period (the first six months after I turn 65), I can be refused Medigap coverage or charged higher rates in the future. Although an Advantage plan may seem more favorable in the short run, I need to analyze that decision on a longterm basis knowing the problems of switching to a Medigap policy in the future. Minnesota has the highest concentration of seniors with Medicare Cost plans. These plans are a hybrid between Advantage and Supplemental policies and may end up being a good choice for me.

My sources of information at the moment are:

Federal government: Websites such as Medicare.gov and Cms.gov are the most reliable source for current Medicare information and regulations.

Insurance Companies: Commercial insurance websites currently provide information about 2016 plans. The 2017 plans will be released in October. Help numbers and retail store appointments are some of the options offered. Most companies also sponsor group sessions which provide information on Original Medicare, plan choices, and differences among the plans. Last year I attended an insurance company-sponsored meeting titled “Medicare 101.” This year I will attend one or more sessions provided by the companies whose plans I am considering.

Miscellaneous Websites: I can Google specific topics and receive multiple website recommendations. It’s a good idea to evaluate the reliability of the data and the source of the info (government vs commercial vs good information vs snake oil).

Books and Publications: Most of the websites mentioned above have free pamphlets and downloadable books. I have already downloaded the 160-page “official U.S. government Medicare handbook” titled Medicare & You 2016 from the Medicare.gov publications link. You can also purchase commercial books such as Medicare for Dummies.

Insurance Brokers: Insurance brokers who specialize in Medicare are a good source for individual help. They earn commissions from the insurance companies and are free for users. In recent years I have worked with an excellent broker for private insurance and recently touched base with the Medicare specialist in the same firm.

Friends with diabetes: I have already gained useful information from some of my Type 1 friends already on Medicare. For learning the ropes of navigating Medicare with an insulin pump and a CGM, they are a practical and valuable resource.

In some ways learning about Medicare is not that different from learning about diabetes. A lot of it seems confusing and overwhelming at first. As you learn more, you begin to understand how things fits together and become more confident about your decision-making skills. At the moment I would argue that my diabetes expertise greatly outweighs my Medicare knowledge, but I think I’m on the right road.

If you have other sources of information about Medicare, please share them in the comments. Advice is always welcomed!

Abby the Black Lab, who is wise about all things related to diabetes, is celebrating a birthday. Her blogposts are some of the most-read posts at Test Guess and Go. Someday I hope to have half as much wisdom as she does.

Some of you may have received an email from me yesterday asking you to sign into Google Docs and check out some I shared with you. I learned about the problem yesterday morning when I was 30 minutes from home and heading to Target before a D-friend meet-up lunch at Costco. My friend Susan from Scottsdale is convinced that there is a proper way to bolus for one slice of Costco pizza, but I have never figured it out. I keep meeting her over and over again to give it another try, but my blood sugars always suffer.

In the Target parking lot, I changed my Gmail password knowing that there wasn’t much more that I could do at that moment and headed into the store, somewhat in a daze. Fortunately my shopping list was only 6 items and I quickly threw them in the cart. I met my friends at Costco and slurped up several Diet Pepsi’s because my stomach was too stressed for pizza. I still haven’t forgiven Costco for switching to Pepsi from Coke, but that’s an issue for another day.

I am usually an expert at deleting posts from Nigerian princes asking for my money and passwords and I have never been hacked before. Unfortunately with 20-20 hindsight I now know that the post that resulted in my email breach was the result of a hack of a DOC friend who had once legitimately shared a document with me on Google Docs. I can see in my Gmail device history that the breach was instigated by a Windows computer in Malaysia. Hopefully new passwords and two-step device verification will prevent another intrusion.

Recently I was accused of being a digital hoarder because I have almost 10,000 emails that haven’t been categorized or deleted. Guilty as charged and yes, I have been sufficiently punished.

If you received a hack email from me, I apologize.

If you receive a suspicious email from a DOC friend or anyone else, check it out before innocently clicking on links as I did.

If you have a magic bolus formula for Costco pizza, let me know. And if you can convince Costco to abandon its Pepsi contract and go back to Diet Coke, I’d appreciate it.

On January 1st I greeted the new year with a 9-mile hike in the Mazatzal Mountains near Sunflower, Arizona. I am an avid hiker and have written extensively about hiking with diabetes. You’ll find some of those posts listed at the bottom of the page.

Not a lot has changed with my hiking in 2016 except for two tech devices.

Dexcom Share: I have often complained that the Dexcom G4 receiver is unreadable in bright sunlight. Animas pumps are even worse. I can’t see a darn thing on the screen. This year is my first experience hiking with the ability to see my Dexcom numbers on my iPhone. It’s fabulous. I can read the numbers with no effort at all. Now when my Dex receiver vibrates, I can pull out my phone to see whether it is a high or low alert and what the number is! Unfortunately I still can’t read my pump screen.

Spot Gen3 Tracker: Despite my emphasis on safety, I have realized for several years that I was missing one device that a hiking group like mine should have. We are quite adventurous and most of our hikes are in mountainous areas with no cell phone coverage. If one of us were to get injured or sick (or have issues due to Type 1 diabetes!), we’d basically be up Sh*t Creek. Most likely we would have to split up the group with some hiking out and driving to get help and others staying behind with the hiker-in-trouble. When you are 5-6 miles away from the car, this is not an ideal situation.

In response to my first hiking post in 2013, Scott Johnson mentioned a satellite-based SOS device that he had used for job-related drives in the boondocks. He wrote:

I think it’s wise to have the glucagon and prep the group. Hopefully you’ll never need any of it. But that’s one of the things about living with diabetes — we have to plan for the absolute worst case scenario.

When I was doing some work that involved a lot of driving in very remote areas I found a device/service called SPOT that used satellites to allow me to call for help, if needed, or broadcast an “I’m Ok” message to loved ones. Thankfully I never had to use the rescue service, but it provided great peace of mind.

Two and a half years later I am now the owner of a Spot Gen3 satellite tracker. According to the company website, the device “provides location-based messaging and emergency notification technology that allows you to communicate from remote locations around the globe.”

That means that I can send out pre-programmed “I’m OK” messages to multiple phone numbers and email addresses. The two routine message options provide GPS coordinates and a link to Google Maps showing my exact location and track. There is a Help, but not life-threatening message that can be sent to designated contacts. Finally there is a SOS button that will summon a cavalry of emergency responders and helicopters.

I hope never to be in a situation where we must use the SOS alert. But if we face a life-threatening emergency, the cost of my annual Spot contract with be worth every dollar. (BTW I received my tracker free due to a pre-Christmas rebate contingent on purchasing an annual monitoring contract.)

For most of my adult life, I have gotten a stomachache starting in mid-December. It doesn’t go away until late afternoon on Christmas Day. It’s obviously related to stress although it feels somewhat reminiscent of the nausea and fatigue that accompany low blood sugar.

Many years ago the stress was probably warranted during the holidays. Lots of shopping, planning, entertaining. More shopping and trying to think of gifts for people who don’t need anything. #FirstWorldProblem. Searching every Target in the Minneapolis area for the one He-Man action figure which sold out in early November. Making grocery lists and checking them twice. Decorating and cleaning house. And so on….

I am the first to admit that at this stage in life, it is unreasonable that I am close-to-puking stressed in December. We no longer exchange gifts with the adults in our family. No sweaters, no dice games, no puzzles, no tacky glass figurines. The grandchildren are fun to shop for although I am not allowed to buy American Girl dolls or video games. The meals are still big, but much simplified compared to 20 years ago. I don’t make cookies and one daughter-in-law handles that.

Unfortunately my stress is a “Pavlov’s dog” reaction to December. It is no longer based on reality but still shows up every year. It is definitely my problem and not the fault of others placing too many demands on me.

I spent much of this December b*tching to friends about how I have to cook prime rib on Christmas Eve and don’t even like it. I grew up in a family where Christmas Eve meant vegetable soup and opening one gift. The big festivities were on Christmas Day. My husband is the grandchild of Scandinavian immigrants and Christmas Eve in his family meant roast beef, lutefisk, boiled potatotes, sylta, potato sausage, pickled herring, rolls, lefse, the Minnesota addition of jello salad, and about twenty kinds of cookies. Christmas Day was another huge meal with turkey and trimmings.

Last weekend one daughter-in-law reminded me that last year I swore that I was going to serve pizza on Christmas Eve! I laughed and said that was a pipe dream. Over the next few hours I began to think “Why Not?” and sent an email to the eight involved adults. The four grandchildren technically had a say and of course chose pizza. One of my sons expressed a desire to have roast beef and my husband wisely kept quiet.

But the decision was PIZZA!

I’ll make a salad ahead of time for the adults and the kids will eat veggies and strawberries. We’ll bake pizzas from Papa Murphy’s. After that we will open gifts and have cookies and coffee. I am looking forward to this and my stomach ache is easing up a bit.

I haven’t completely thrown tradition out the window. We will use the Christmas tree plates and sit at the dining room table. We will open Christmas poppers which contain jokes, tiny toys, and paper crowns. We will wash the dishes before gift opening. Most of the day and evening will remain unchanged.

November is a month of change in Minnesota. We move from the somewhat warm days of late October to cold wintry weather by the end of the month.

It is also a busy month for me when it comes to diabetes. 1) It is Diabetes Awareness Month with special events and increased advocacy. 2) JDRF sponsors a TypeOneNation Summit in the Minneapolis area. 3) My diaversary is in November. 4) The Big Blue Test is in full swing and World Diabetes Day is coming soon.

Below you’ll find some outdoor photos that scream “November!”

I have been raking for a few weeks now, but one maple tree refuses to shed its leaves. Our last leaf pick-up is Friday and I am hoping that these leaves will drop before then. If that doesn’t happen, my fingers are crossed that strong winds next week will blow the delinquent leaves into my neighbor’s yard….

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The signage at Hyland Lake Park Reserve where Abby the Black Lab and I walk several times a week has changed in anticipation of winter. The trail labeled for dog walkers, bikers, and rollerbladers in the summer is now marked for dog walkers and snowshoers.

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Although I shudder at the idea of snow, we have already seen flurries this fall. Once it gets colder, the snowmaking machines in Hyland Park will start blowing snow for the nearby cross-country ski trail. Although I live in the suburbs, I can see downhill and cross-country ski trails from my house. Just barely out of sight is a 70-meter ski jump. And you wonder why I spend my winters in Arizona!

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An apple on the ground and you question why I am showing you my garbage. My neighbors have apple and crabapple trees and fruit litters my backyard. The fruit-eating animals I have seen in the last week include coyotes, birds, deer, squirrels, and Abby the Black Lab. Who left the half-eaten apple? Probably Abby who really prefers deer poop. Yeah, we’ve got piles of that in the yard also.

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Below you’ll find some November photos that scream “Diabetes!”

Diabetes social media has been saturated this month with blue photos as part of the JDRF T1D Looks Like Me campaign. I have a long history of hiding my diabetes, but thanks to my years in the DOC, I proudly share my photo.

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Saturday was the JDRF TypeOneNation Summit for the Minneapolis area. Author and CDE Gary Scheiner (Think Like a Pancreas) shared his wealth of knowledge in both the keynote talk and a session about interpreting CGM data. I also attended a talk by the incredible Jay Hewitt. Jay is an Ironman triathlete who was a member of the U.S. National Triathlon Team and raced with Type 1 diabetes.

Remember to follow the hashtag #WDDchat15 on Saturday, Nov. 14 to participate in the World Diabetes Day #DSMA TweetChat. The schedule can be found here, but stay tuned to @DiabetesSocMed on Twitter for updates.

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And finally, today marks 39 years since I was diagnosed with diabetes in 1976.